An important book on cancer

At the urging of a relative, who lent it to me, I recently read what some have labeled the most important book on cancer published in my lifetime. The book is The Emperor of all Maladies: A Biography of Cancer, by Siddhartha Mukherjee, and it won, among other awards, the Pulitzer Prize for non-fiction.

The book is written so as to be accessible to lay persons, although it has many notes, and a good index, so those seeking further information can explore further.

So what's it about? It's about the history of our attempt to prevent, and/or cure, cancer, from the beginnings of medical science until almost the present. Many names of important scientists and health professionals, and some philanthropists, politicians and what we now call activists are included, along with a sentence or more on what they were, or are, like. Many developments in the history of our work with cancer are described, such as establishing the link between tobacco and lung cancer.

What's the message of the book? More correctly, what are the messages of the book?

One of them is that cancer is many different ailments. The Human Genome Project "maps" the DNA bases of "normal" people. It's an enormous trove of data. The Cancer Genome Atlas, referred to in the book, and under development, promises to be much larger than the map of the human genome.

Another message is that we can't expect to cure cancer until we understand the workings of normal human cells better than we do now. Cancer occurs when the mechanisms that cause and control cell multiplication get out of kilter. Those mechanisms are complex. Our understanding is getting there, making some strides that scientists of a couple of generations ago wouldn't have even understood, but we aren't there yet.

Another message is that government, business, or academic bureaucracy can get in the way of doing some good things for people that are in desperate need. That's hardly a surprise, but the story of cancer has too many examples of this sort of thing.

Another message, although Mukherjee doesn't put it in those terms, is the way in which our progress toward curing and preventing cancer illustrates the thesis of The Structure of Scientific Revolutions, by Thomas S. Kuhn. Kuhn claimed that science changes, not so much because of experiments, as because of revolutions in the thinking of the scientific community. These revolutions usually leave some older scientists bypassed -- they are stuck in an old way of looking at natural phenomena, and don't ever accept more correct and fruitful ways. Over and over, this happened in the biography of cancer.

We have made some progress, in preventing some forms of cancer, and in curing some others. But there are many cancers we don't have much of a handle on yet, and many patients who suffer through chemotherapy without much benefit. A sobering story.

Cancer is such a complex subject that it is probably not possible to come close to understanding it without reading a book such as Mukherjee's, or the equivalent. I'm glad that I understand this disease, which stands a good chance of ending my own life, a little better. (I am not aware that I have any form of cancer, but you never know, especially the older you get.)

Thanks for reading.